A new study published in Spine examines the reliability of the National Inpatient Sample and National Surgical Quality Improvement Program data for anterior cervical discectomy and fusion.
The study authors analyzed a retrospective cohort of study patients undergoing ACDF in NIS and NSQIP; 112,162 patients from the NIS and 10,617 patients in NSQIP were included in the study. The study authors found:
1. There was a small difference in the patient demographics between the two data sources and a larger, more distinct difference in patient comorbidities. The intraoperative variables were also distinctly different between the two databases.
2. The dependent risk factors identified between the two databases were mortality, cardiac complications and postoperative sepsis; most of the risk factors were in both, but most were present primarily in one database. These findings show the validity and importance in risk stratification for patients.
3. Researchers found the NSQIP a more accurate predictor for complications based on average areas under the receiver operating curve. The results were similar across the multivariate models.
4. After conducting a complication rate analysis, the researchers found the NSQIP reflected the importance of 30-day patient follow-up for both inpatient and outpatient procedures. The NIS data did not always include the 30-day follow up.
5. The study authors concluded, "Despite having largely similar patient demographics, the study highlights critical risk factors for ACDF and demonstrates how different patient profiles can be across NIS and NSQIP, the impact of such differences on identification of independent risk factors, and how NSQIP is ultimately better suited for adverse-event studies."
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